Impact of Participation in Actual Resuscitation Events on Nurses’ Self-Efficacy and Attitudes Toward Cardiopulmonary Resuscitation in Acute Care: Mixed Methods Research

BACKGROUND: Cardiopulmonary resuscitation (CPR) is the cornerstone of acute response to cardiac arrest. Psychosocial factors, such as self-efficacy and attitudes toward CPR, play an important role in determining whether and how effectively nurses perform under the intense pressures of a real cardiac arrest. OBJECTIVES: To determine the impact of nurses' participation in actual resuscitation events on their self-efficacy and attitudes toward cardiopulmonary resuscitation. METHODS: A mixed-method study design was employed. Quantitatively, a cross-sectional survey of 362 nurses identified predictors of CPR attitudes and self-efficacy through regression analysis, while qualitatively semi-structured interviews with 20 nurses provided in-depth insights using Braun and Clarke's thematic framework. RESULTS: Quantitative findings indicate that only 37.6% of nurses demonstrated positive attitudes toward CPR, and 46.4% reported high self-efficacy. These were more prevalent among older, female, non-Saudi nurses with advanced qualifications, critical care experience, or prior exposure to CPR policies and training. Qualitative findings reinforced that real CPR experience boosts both confidence and attitude. DISCUSSION: Participation in actual resuscitation events, awareness of institutional CPR policies, and completion of advanced CPR training significantly contribute to improving nurses' attitudes and self-efficacy. This study emphasizes that structured education, regular training, and simulation improve nurses' resuscitation skills, with tailored support boosting confidence and outcomes.